3. PROCONVULSANT PLANTS

Plants containing nicotinic alkaloids lead to sympathetic over stimulation. In severe cases these patients can develop coma, seizures, cardiovascular collapse followed by respiratory paralysis. Tobacco and Poison Hemlock are well known plants that contain nicotinic alkaloids.

5. PLANTS THAT CAN INDUCE MUSCLE SPASM

Strychnine poisoning was a common pharmaceutical poison in the past. Plants containing strychnine give rise to similar clinical manifestations. Strychnine inhibits glycine, an important inhibitory neurotransmitter in the spinal cord. This leads to generalized muscle contractions.

MUSHROOMS

Unintentional ingestion of mushrooms is still an important problem with deaths occurring in some parts of the world. Toxic mushrooms can present various clinical presentations due to the differing toxins present. Cyclopeptides ( e.g. Amanita phalloides), glyromitrin ( e.g. G. californica), Muscarine (Clitocybe dealbata), Coprine e.g. C. atramentarius) and Psilocybin (e.g. C. cubensis) are some of the toxins present in this group of mushrooms.

Objectives

Identify clinical features of mushroom poisoning by different mushrooms

COLCHICINE-CONTAINING PLANTS

Colchicine cantained in plants such as Gloria superba and Colchicium autumnale inhibits microtubular formation within cells. This leads to interference with cellular mitosis and cell death. Interference of microtubular functions in all organs of the body can result in multi organ failure with the greatest effect manifesting in rapidly dividing cells such as the gastrointestinal tract.

Initial clinical presentation is in the gastrointestinal tract with nausea, vomiting and diarrhoea leading to volume depletion. In severe poisoning this initial clinical stage leads to multiorgan failure and finally death or recovery.

Objectives

Describe the mechanism of action of colchicine

Describe clinical sequealae of colchicine toxicity

Describe predictors of toxicity

Outline the management of acute poisoning and resuscitation of a patient with severe colchicines toxicity